LASIK outcomes are enhanced

Surgical and technology advances, customized procedures help raise the bar

Encinitas, CA—Outcomes of LASIK have continued to improve thanks to advances in technology and medical management, Jim Owen, MD, MBA, said recently.

Dr. Owen

"Results in the current era of LASIK using a customized wavefront-guided (WFG) ablation with a femtosecond laser for flap creation have made the refractive procedure better than ever with efficacy, predictability, and quality of vision outcomes that can truly be described as phenomenal. Complications still can occur, but the incidences of these events are quite low and patient satisfaction after LASIK is very high," said Dr. Owen, in private practice, Encinitas, CA.

Results from a number of studies demonstrate that the WFG technique improves LASIK refractive predictability and provides patients with better quality of vision compared with a conventional ablation. Steven Schallhorn, MD, and David Tanzer, MD, have been leaders in research performed at the U.S. Naval Medical Center, San Diego, evaluating the potential benefits of WFG LASIK.

Dr. Owen highlighted the results from a matched analysis comparing 500 eyes operated on with conventional LASIK and 170 eyes that underwent a WFG procedure to highlight the superiority of the customized procedure.

At 3 months, mean MSE was close to emmetropia in both the conventional and WFG LASIK groups, +0.01 and –0.16 D, respectively. The proportion of eyes achieving 20/20 or better UCVA was high in both groups, 91% and 93%, respectively. The WFG procedure did have a slight advantage for predictability, with 90% of WFG eyes achieving MSE within 0.5 D of target compared with 84% of eyes in the conventional LASIK group.

WFG benefits reported

Analyses of changes from baseline BCVA and low-contrast acuity showed statistically significant differences favoring the WFG group—a higher proportion of eyes gained lines. Additionally, the proportion of patients with reduced complaints about halos at night after surgery was higher among those who had the WFG procedure.

Evaluation of night driving performance using a simulator showed improvement in both the ability to detect and identify hazards after surgery in patients who underwent WFG surgery.

"Low contrast acuity was found to be a good predictor of skills necessary for naval aviators, and it is an indicator of the quality of vision for patients in the everyday world," he said.

All-laser LASIK

All LASIK procedures begin with flap creation, and the femtosecond laser has become the most commonly used technology for making the lamellar cut. First introduced less than a decade ago, the innovator in femtosecond lasers for ophthalmology, the IntraLase (Abbott Medical Optics), is currently in its 5th generation (iFS Advanced Femtosecond Laser) and offers multiple benefits compared with previously available versions, Dr. Owen said.

"Its features include a 150 kHz repetition rate for faster flap creation time, use of tighter spot separation that reduces energy per pulse, and greater versatility in flap geometry and side cut options. Use of this femtosecond laser results in a smoother bed, a lower incidence of opaque bubble layer formation, and a flap that is more stable after surgery," he said.